Individual
ERIC GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6801 DIXIE HWY STE 134, LOUISVILLE, KY 40258-3952
(502) 447-4500
(502) 449-0108
Mailing address
6801 DIXIE HWY STE 134, LOUISVILLE, KY 40258-3952
(502) 447-4500
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
262794
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2017
Last updated
10/07/2021
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